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Prematurity - Coggle Diagram
Prematurity
Social / Psychological Support
Family intergration and supoprt
Bonding
Development care NIDCAP
Kangaroo
Definition
The birth of a baby at fewer than 37 weeks gestational age
Gestation age catagories
Extremely preterm: <28/40
Very preterm: 28 - 31+6
Preterm : <37/40
Moderately preterm 32+0 - 33+6
Late preterm 32+0 - 36+6
Weight Categories
Extremely low birth weight <1000g
Very low birth weight <1500g
Low birth weight <2500g
Main Issues
Organ / Tissue immaturity
Impaired transition/postnatal adaptation
Thermal instability
Respiratory
Respiratory Distress Syndrome (RDS) - Surfactant
Pathogenesis
Failure to oxygenate
Progressive atelectasis
Underdeveloped lungs
Increased chest wall compliance
Failure to achieve FRC - functional residual capacity
Surfactant deficiency
Support
CPAP
Mechanical ventilation
High flow nasal cannula
Low low oxygen
Aim
Minimally invasive ventilation
Avoidance of ventilation associated trauma
BPD/CLD Bronchopulmonary dysplasia / Chronic Lung disease
Pathogenesis
Restriction of alveolar surface
Underlying inflammation
Abnormal alveolar and lung vascuar development
Definition
O2 requirement at 36/40
Prognosis
Self correcting
Can die tho
Apnea of Preamturity
Aetiology
Central
Obstructive
Mixed
Management
Caffeine
Haematology
Anaemia of prematurity
Trasfusion
Thrombocytopenia
Prognosis and Outcomes Variables
Gestation
Antenatal care
Centre / county dependend
Thermal Management
Loose heat due to body mass to surface area ratio
<1500g in incubator
Cardiovascular
Postnatal Adaptation
Circulation instability
Hypotension
Management
Monitoring and therapy
Patent Ductus Arteriosis
Management
Unkonw whether beneficial to close
CNS
Intraventricular Harmorrhage IVH
Large vascular ventricles in babies
Graded
Grade 4 has the most impact
Periventricular Leukomalcia PVL
Necrosis of white matter near the lateral ventricles
Infection
Bacterial
EArly onset 72 hrs
Pathogens
GBS
E. coli
Preterm labour trigger
Late onset
Often nosocomial
Pathogens
CONS
MSSA
Gram (-) bacilli
Diagnosis
Clinical and lab
Management
Abx
Supportitive
ABx stewardhsip
Other
Fungal
Viral
RSV
Access in a Premie
Central
UVC
Umbilical vein catheter
UAC
Umbilocal artery catheter
PICC line
UVC and UAC
Peripheral
GIT
Necrotising Enterocolitic NEC
-Multifactorial complex disease
Prematurity
Microbiom
Enteral feeding
-Circulation instability / hypoxia
Surgical if strictures / blockages
Modified Bell's Criterial
Clinical and radiological diagnostic critera
Opthalmology
Retinopathy of prematurity ROP
Screening
<1500
<32/40
Management
Anti VEGF
Laser
Abnormal growth of vessels behind the retina
Complications
Blindness
